HomeMy WebLinkAbout01-03-12BUREAU OF INDIVIDUAL TAXES 't"f ',;'ONCE OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~ APPRAT'SE NT, ALLOWANCE OR DISALLOWANCE
PO BDX 280601 OF-DE~IkCRIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
Ct.ERK
CR~'Nf;P1 ~ ~~; ~~ 'fir
TERRY CLAYG~~I~A{~ ~;~ "P ~`i l 0q
1485 HUNTLEY CT
YORK PA 17408-4490
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1548 EX AFP C12-lll
DATE 01-03-2012
ESTATE OF SIMMONS CAROLINE R
DATE OF DEATH 10-16-2011
FILE NUMBER 21 11-1140
COUNTY CUMBERLAND
SSN/DC 168-24-4270
ACN 11170329
APPEAL BY DATE:03-03-2012
(See reverse side under Objectious)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~"> RETAIN LOWER PDRTION FOR YOUR RECORDS <'~
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REY-1548 EX AFP C12-11)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 01-03-2012
ESTATE OF:SIMMONS CAROLINE R DATE OF DEATH:10-16-2011
FILE NO.: 21 11-1140 S•'
TAX RETURN WAS: CX)
FINANCIAL INSTITUTION: MEMBERS
TYPE OF ACCOUNT: C SAVINGS
DATE ESTABLISHED 05-12-2009
Account Balance
Percent Taxable
Amount Sub]ect to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
COUNTY:CUMBERLAND
i/D.C. NO.: 168-24-4270 ACN: 11170329
ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
1ST FCU ACCOUNT NO.: 356509-41
( ~ CHECKING ( )TRUST CX)TIME CERTIFICATE
86,615.97
X 0.500
43,307.99
- .00
43,307.99
Y .045
1,948.86
NOTE: TO ENSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
11-17-2011 CD015220 97.44 1,448.86
TOTAL TAX PAYMENT 2,046.30
BALANCE OF TAX DUE 97.44CR
INTEREST AND PEN. .00
TOTAL DUE 97.44CR
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. n
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~J~?